Benazir Bhutto’s return to Pakistan had a mad recklessness about it which give today’s events a horrible inevitability. As I always say when I’m asked about her, she was my next-door neighbor for a while - which affects a kind of intimacy, though in fact I knew her only for sidewalk pleasantries. She was beautiful and charming and sophisticated and smart and modern, and everything we in the west would like a Muslim leader to be - though in practice, as Pakistan’s Prime Minister, she was just another grubby wardheeler from one of the world’s most corrupt political classes.

Since her last spell in power, Pakistan has changed, profoundly. Its sovereignty is meaningless in increasingly significant chunks of its territory, and, within the portions Musharraf is just about holding together, to an ever more radicalized generation of young Muslim men Miss Bhutto was entirely unacceptable as the leader of their nation. “Everyone’s an expert on Pakistan, a faraway country of which we know everything,” I wrote last month. “It seems to me a certain humility is appropriate.” The State Department geniuses thought they had it all figured out. They’d arranged a shotgun marriage between the Bhutto and Sharif factions as a “united” “democratic” “movement” and were pushing Musharraf to reach a deal with them. That’s what diplomats do: They find guys in suits and get ‘em round a table. But none of those representatives represents the rapidly evolving reality of Pakistan. Miss Bhutto could never have been a viable leader of a post-Musharraf settlement, and the delusion that she could have been sent her to her death. Earlier this year, I had an argument with an old (infidel) boyfriend of Benazir’s, who swatted my concerns aside with the sweeping claim that “the whole of the western world” was behind her. On the streets of Islamabad, that and a dime’ll get you a cup of coffee.

As I said, she was everything we in the west would like a Muslim leader to be. We should be modest enough to acknowledge when reality conflicts with our illusions. Rest in peace, Benazir.

The emotionally shaken father of a 16-year-old girl in an irreversible coma at Montefiore

Medical Center is wavering in his opposition to ending what’s left of her life.

“I’m 85% changed in my mind now, but I don’t know the legality,” said Leonard Peters, whose

daughter Javona Peters is in a permanent vegetative state after what was supposed to be a

routine operation on Oct. 17.

“I’ve got to think about it. I’ve got to talk to my lawyer,” he said, a day after the Daily

News reported on the teen’s condition. “I mean, if nothing is working for Javona, I don’t

see the point now.”

Until Wednesday, Peters opposed pulling the plug. “I don’t give life and I cannot take a

life,” he told The News last week.

Javona’s mother, Janet Joseph, has said she wants “to let Javona go in peace” by taking her

off her feeding tube. The case is set for a Jan. 7 hearing in Bronx Supreme Court.

The case, first disclosed Wednesday in The News, has attracted national media attention to

what could be another right-to-life battle, as in the Terri Schiavo case.

Javona was a healthy, outgoing high school junior until she went into the operating room 10

weeks ago. Now she is blind, deaf and unable to move, think or eat on her own.

Joseph has asked the courts to appoint her Javona’s guardian so she can finally pull the

plug and also begin a medical malpractice action against the hospital.

Javona’s parents say hospital officials have never satisfactorily explained what happened to

their daughter.

Montefiore maintains her condition was caused by oxygen deprivation triggered by an

“extremely rare” allergic reaction to “a routine anesthesia agent.”

Javona’s operation was a ventriculostomy, a routine procedure that involves boring a hole in

the brain to drain cerebral fluid into a cavity.

Hospital spokesman Steve Osborne said Javona’s case “was a completely unexpected outcome.”

He said the hospital has done an investigation, but he wouldn’t disclose results.

Meanwhile, the hospital has told Joseph it’s time for her daughter to be transferred to a

permanent nursing facility. The hospital contends there is nothing more it can do for

Javona.

Millions of Kenyans waited in the muggy darkness for the polls to open and for a chance to scratch their X’s in a presidential election that is predicted to be the tightest race in the country’s history — and perhaps the greatest test yet of Kenya’s young, multiparty democracy.

The contest pits the incumbent, Mwai Kibaki, a man who has a reputation as a courtly gentleman and economics whiz but also as a tribal politician, against Raila Odinga, a rich, flamboyant businessman who rides around in a bright red $100,000 Hummer and is running as a champion of the poor.

The polling places were packed with young women carrying babies on their backs, students chatting on cellphones, wrinkled old men teetering on canes and muscled young men smelling as if they had just tumbled out of a bar. Security was tight. Truckloads of helmeted soldiers prowled the slums. Policemen swung canes to beat back throngs of voters trying to squeeze into voting booths.

“We want change!” yelled Abdi Mubarak, who works in a mosque and who said he voted for Mr. Odinga.

That change may come. Though official results are not expected to be released until Friday, most polls in the past several months forecast that Mr. Odinga would win the popular vote, and the heavy turnout on Thursday was said to work in his favor. It seems that he has tapped into frustrations percolating for some time in Kenya, which enjoys one of the strongest and most stable economies in Africa but suffers from deep tribal divisions. Mr. Odinga has built a coalition of the Luo, the Luhya, the Masai, the Somali and many other tribes who say they feel that the Kikuyu, Kenya’s biggest tribe, accounting for a quarter of the population, has been politically dominant for too long.

On Thursday, this played out behind the cardboard booths where voters hunched over their ballots. Of more than a dozen people interviewed, not one crossed tribal lines when voting. Mr. Odinga, 62, is a Luo. Mr. Kibaki, 76, is a Kikuyu. And the third notable politician in the presidential race, Kalonzo Musyoka, 54, is a Kamba.

“I’m for the president,” said David Ndagwa, a stocky vendor of vegetables who said he was a Kikuyu. “He’s brought progress.”

Tribes aside, there are other issues in this race. Mr. Odinga wants to devolve power from the center of the country and grant Kenya’s rural areas more autonomy. Mr. Kibaki has been running strong on education and has already delivered on his promise of free primary school education for all Kenyans. Mr. Musyoka is a former foreign minister and has said he is the one to expand Kenya’s links to the wider world. He has run a distant third in polls.

However, Kenyan law necessitates that to become president, a candidate must win a seat in Parliament and secure at least 25 percent of the votes in five out of eight of the country’s provinces. This electoral fine print may mean that even if there is a clear winner in the popular vote, there could be a runoff.

The president’s party has been trying to block Mr. Odinga from winning the presidency by backing candidates in Mr. Odinga’s parliamentary district, which includes Kibera, a sprawling shantytown on the outskirts of Nairobi that is known as Africa’s largest slum. At the same time, Mr. Kibaki’s support is concentrated in a few provinces, and there is a real chance he may not clear the five-out-of-eight hurdle. Either situation could produce an inconclusive election result and turbulence.

There are more than 14 million registered voters in Kenya and election officials said the turnout on Thursday seemed substantially higher than the 57 percent in the last presidential race, in 2002. Voters on Thursday also chose members of Parliament and local government officials.

There were some problems, though. Many polling places did not open on time and as a result voters waited in line for hours — without moving. Many people also complained that voter lists were incomplete. Mr. Odinga said that even he could not find his name on the roster in Kibera when he tried to vote in the morning. But after he complained to election officials, he was allowed to cast a vote, along with others who produced valid identification. Mr. Odinga stepped from the voting booth into a sea of cheering fans.

Election observers said that although many polling places were a bit chaotic, the vote seemed to be free and fair.

“We haven’t seen any corruption,” said Rhoda Mackenzi, a Kenyan observer. “And we’ve been looking, for sure.”

Michael E. Ranneberger, the American ambassador to Kenya, seemed pleased.

“The process has not been without its difficulties,” he said, “but over all, when you look at various factors, it has gone well.”

Source: WashingtonPost

Here are some of the latest health and medical news developments, compiled by editors

ofHealthDay:

U.S. Ruling Allows Insurance Cutbacks for Retirees Over 65

U.S. employers can cut or eliminate altogether health benefits for retired people over age

65, the Equal Opportunity Commission ruled Wednesday.

The agency’s decision permits the creation of two classes of retirees — people younger than

65 who are entitled to more comprehensive benefits, and people 65 and older who can be

afforded limited health benefits from their former employers or none at all,The New York

Timesreported. At age 65, many retirees become eligible for Medicare.

Employer-sponsored health premiums have risen an average of 6.1 percent this year and a

total of 78 percent since 2001, the newspaper reported, citing statistics from the Kaiser

Family Foundation.
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The commission said employers are not required by federal law to offer health benefits to

either active or former employees. However, in issuing its edict, the commission noted, “The

final rule is not intended to encourage employers to eliminate any retiree health benefits

they may currently provide.”

Nonetheless, the AARP and other organizations representing seniors condemned the decision.

“This rule gives employers free rein to use age as a basis for reducing or eliminating

health care benefits for retirees 65 and older, said AARP attorney Christopher Mackaronis,

who said the ruling could affect as many as 10 million people.

In June, a U.S. Court of Appeals decision upheld the commission’s right to establish this

sort of exemption to the Age Discrimination in Employment Act of 1967. The AARP has asked

the U.S. Supreme Court to review that decision, theTimessaid.

In related news, a federal judge on Wednesday struck down a portion of a San Francisco

program that provided health care benefits to some 82,000 uninsured residents, theAssociated

Pressreported.

Employers cannot be forced to subsidize the city government’s plan, U.S. District Judge

Jeffrey White ruled. “By mandating employee health benefit structures and administration,

those requirements interfere with preserving employer autonomy over whether and how to

provide employee health coverage, and ensuring uniform national regulation of such

coverage,” White’s decision said.

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Avastin Improves Survival in Women With Advanced Breast Cancer: Study

Avastin (bevacizumab), a drug that inhibits the growth of blood vessels that supply tumors, slows the progression of metastatic breast cancer and prolongs survival, researchers wrote in the Dec. 27 issue of theNew England Journal of Medicine.

Their study of 722 women with recurrent breast cancer found that women who took Avastin combined with standard chemotherapy had progression-free survival of 11.3 months, compared to 6 months on standard chemotherapy alone.

“This therapy is a one-two punch! You hit the tumor with the chemo and sabotage new blood vessel growth by restricting its oxygen supply with Avastin,” Dr. Melody Cobleigh, a study co-author and director of the Coleman Foundation Comprehensive Breast Center at Rush University, said in a statement.

Avastin not only slowed the growth of tumors, it also doubled the remission rate — the shrinkage of tumors by 50 percent or more, the statement said.
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About 178,000 women will be diagnosed in the United States this year with breast cancer, and an estimated 40,000 will die from the disease, the American Cancer Society says.

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New Drug Treats Blood Loss From Surgery

Voluven was approved Thursday by the U.S. Food and Drug Administration to prevent and treat significant loss of blood from surgery.

The intravenous solution, containing a synthetic starch that does not dissolve in water, expands the volume of blood plasma. This helps draw the blood into the small vessels called capillaries, preventing the potentially fatal cases of shock that can result from a massive loss of blood, the agency said in a statement.

In clinical testing, Voluven proved as safe and effective as other so-called “blood volume expanders” such as Hespan.

Voluven (6% hydroxyethyl starch 130/0.4 in 0.9% sodium chloride injection) is produced by the German firm Fresenius Kabi.

Children’s Blocks Recalled for Choking Hazard

About 170,000 sets of toy blocks made in China are being recalled because the plastic covering on the blocks can detach, posing a choking hazard, the U.S. Consumer Product Safety Commission said Thursday.The Tot Tower blocks, distributed by eeBoo Corp. of New York City, were produced in sets of 10 blocks with various images and themes. Sold at specialty and gift shops across the United States from January 2003 through September 2007, sets cost about $20 each.The company has received two reports of the plastic laminate detaching from the blocks. No injuries have been reported.

Consumers should immediately take the blocks away from children and return them to the place of purchase for a refund or replacement toy. For more information, contact eeBoo at 800-791-5619.

—–
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Diabetic Test Strips Recalled

Certain diabetic test strips used with Bayer’s Contour TS Blood Glucose Meter are being recalled, because they may overstate how much blood sugar a user has by up to 17 percent, the U.S. Food and Drug Administration said.

An error in the strips’ manufacturing process led to the recall, Bayer said. Affected strips have lot numbers beginning with WK, followed by the characters 7D, 7E, 7F, or 7G, then followed by a series of additional letters and numbers.

The strips were sold mostly by mail order in the United States and may also have been distributed in France, Austria, Turkey, Korea, and Mexico.

The recall affects only the strips and not the meters themselves. Other strips and meters produced by Bayer are unaffected.

Source: WashingtonPost

Some Groups Call Law Unneeded and Intrusive

NEW YORK, Dec. 27 — New Jersey this week launched one of the most ambitious efforts in the

country to control mother-to-child transmission of HIV, making screening tests mandatory for

all pregnant women in the state beginning next year.

A bill signed into law Wednesday by the Senate president, Richard J. Codey, in his capacity

as acting governor, requires two tests for pregnant women, at the beginning of the pregnancy

and again in the third trimester, unless the mother objects. If the mother objects, the

objection will be noted and the newborn will then be tested for HIV, with the only exception

being on religious grounds. Newborns will also be tested if the woman tests positive.

Just four other states have mandated testing for pregnant women, and three more– including

New York — require screening of newborns. But New Jersey’s law appears to go further by

requiring both.

The mandatory screening has raised privacy concerns. The American Civil Liberties Union of

New Jersey and the state’s chapter of the National Organization for Women both questioned

whether the mandated tests violate a woman’s right to privacy and the right to make her own

medical decisions.
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Riki E. Jacobs, executive director of the Hyacinth AIDS Foundation, a New Jersey nonprofit

helping people living with AIDS, said the law is unnecessary and comes when the state should

be focused on expanding care for pregnant women. “I am adamantly opposed to this bill. New

Jersey already reduced the perinatal rate of transmission with mandatory counseling of

pregnant women,” she said. “The issue is getting those women who are not in prenatal care in

for services and testing.

“I definitely think it is an invasion of privacy,” Jacobs said. She said women choose to

test their babies in 98 percent of cases, so the new law’s mandatory provisions for testing

children are not needed: “The fact that we assume women won’t choose to test is ludicrous

and wrong.”

But in the end, lawmakers decided that the risk of exposing children to the infection

outweighed those concerns.

While men represent the majority of new HIV and AIDS cases in the United States, women now

account for an increasing share, from just 8 percent of new diagnoses in 1985 to 27 percent

in 2005, according to the Kaiser Family Foundation. Of the estimated 1.2 million people

living with HIV/AIDS in the United States in 2005, about 300,000 were women, and the vast

majority of them were between 25 and 44 years old.

The U.S. Centers for Disease Control and Prevention, among other groups, has been

recommending that HIV screening become a routine part of prenatal tests. The CDC recommended

HIV tests become a routine part of the battery of prenatal tests, and that there be no

separate written consent required.

Mother-to-child transmission of the disease — during pregnancies and through breast-feeding

– peaked in the United States in 1992, according to the Kaiser Family Foundation, which

reported that the number of cases since then has dropped “dramatically” because of early

detection and the increased use of antiretroviral therapy, which lowers the risk of

transmission to less than 2 percent.

The majority of those new cases that still occur are mostly among black Americans,

reflecting the changed demographic of the epidemic since it was first identified.

According to the CDC, 100 to 200 children a year are infected by their mothers. As of 2005,

the last year for which figures are available, there were 6,051 people in the United States

living with HIV/AIDS who had been infected perinatally — during pregnancy or

breast-feeding.

Of those, 66 percent were black and 20 percent identified as Hispanic.

In New Jersey, a June report by the state’s health department reported 78 percent of those

with HIV and AIDS were members of minority groups. That report also found that New Jersey

has a significant female population living with the disease, 37 percent of the total.

In signing the bill at a local hospital, Codey said, “We can significantly reduce the number

of infections to newborns and help break down the stigma associated with the disease.”

He added: “For newborns, early detection can be the ultimate lifesaving measure.”

New Jersey records about 115,000 births each year. While there were no recorded

mother-to-child transmissions this year, as of the June report, there were two children born

infected in 2006 and seven born infected in 2005, according to the health department.

Source: WashingtonPost

A plan to offer online video rentals could turn up the heat on Netflix and Amazon—and

reinvigorate interest in Apple TV

In much the same way it upended online distribution of music, Apple may now be poised to

redefine the way movies are rented online. According to published reports, Apple (AAPL) and

Fox (NWS) plan to bring movie rentals to Apple’s popular iTunes Store, and through that to

its family of iPod media players and the iPhone. The two companies are said to have

concluded an agreement that will have Fox movies available for limited-time viewing via

iTunes as they are released on DVD.

Online film rental is only now getting off the ground. Netflix (NFLX), which specializes in

mail-order movie rentals, recently launched an online movie rental service that lets

consumers order movies and watch them instantly on a computer. Netflix said in August that

its customers had watched some 10 million movies and TV shows on their computers. Meanwhile

Amazon.com (AMZN) and TiVo (TIVO) have launched a partnership to let owners of TiVo digital

video recorders purchase or rent movies and TV shows from Amazon’s Unbox video download

service. And in August, Movielink, an online on-demand movie service backed by major movie

studios including Universal, Paramount (VIA), MGM (MGM), and Warner Bros. (TWX), was

acquired by Blockbuster (BBI).

Some companies have scrapped video download efforts altogether. Wal-Mart Stores (WMT) closed

its download service on Dec. 21, according to a statement on its Web site. Hewlett-Packard

(HPQ) discontinued the service because the market for paid video downloads did not perform

“as expected,” Reuters reported, citing an HP spokesman.
Apple TV May Get Juiced

The problem with many of these services is that they’re hard to use and their movies don’t

work with iPods, among the most popular digital entertainment devices on the market, says

JupiterResearch analyst Michael Gartenberg. “Apple will be bringing to the table its famous

ease-of-use and its popular player,” Gartenberg says. “For all intents and purposes, if

something doesn’t work with the iPhone or the iPod, it doesn’t exist.” Some of the services

aren’t compatible with Apple’s Macintosh computers, either.

As with all things Apple in the realm of digital media distribution, the devil will be in

the details. While rumors have swirled about an iTunes-based movie rental service at least

since mid-2007, no details have been released on prices or on how widely consumers can use

rented movies. Apple Chief Executive Steve Jobs may announce the rental plan on Jan. 15,

during his keynote address at the Macworld Expo in San Francisco. A Fox spokesman declined

to comment, and Apple didn’t respond to a request for comment.

As much as the Apple-Fox deal could shake up online film rental, it’s also likely to breathe

new life into Apple TV, a digital media also-ran. The device is a small, flat box that

connects to a TV and uses a home network to play video and music from a consumer’s iTunes

account stored on a Mac or Microsoft (MSFT) Windows PC. While Apple has sold more than 100

million TV shows and 2 million movies over iTunes, the market largely ignored Apple TV.

Apple’s Jobs has even publicly described it as “a hobby.”

Source: Canada

The world’s most unstable nuclear-armed nation is plunging deeper into crisis.

Yesterday’s assassination of former Prime Minister Benazir Bhutto has thrown into disarray Pakistan’s attempt to restore democracy, eliminating a leading contender for power days before a national election and highlighting the growing reach of extremists.

Ms. Bhutto, a Harvard-educated politician who enjoyed U.S. support, had been expected to do well in elections scheduled for Jan. 8, possibly becoming prime minister once again. Her death has deprived Pakistan’s embattled president, Pervez Musharraf, of his strongest potential ally in the battle against the rising tide of radical Islam in this nation of more than 160 million people.

Yesterday’s attack brought home how the world’s second-most-populous Muslim nation totters on the brink of becoming a failed state, with potentially devastating consequences for neighbors like India and Afghanistan, and for the West. The murder was the latest in the series of suicide attacks that now occur in Pakistan with a frequency approaching that of Iraq, as Taliban-style Islamic insurgents overtake swaths of the countryside.

Ms. Bhutto, 54 years old, was killed by a man who first shot her and then blew himself up following a campaign rally in the city of Rawalpindi near Islamabad, witnesses said. Twenty people were killed in the blast.

One of the first women to lead a modern Muslim nation, Ms. Bhutto has long attracted the ire of Islamist extremists. She was the target of another assassination attempt on Oct. 18, the day she returned to Pakistan after eight years of self-imposed exile. More than 100 people died in that bombing.

Though no one claimed responsibility for yesterday’s attacks, President Musharraf blamed radicals linked with al Qaeda and the Taliban. “This is the work of those terrorists with whom we are engaged in war,” he said in a nationally televised speech. “The nation faces the greatest threats from these terrorists.”

The Bhutto assassination puts President Musharraf, a close U.S. ally, in a tight spot: He was counting on the participation of Ms. Bhutto and her large Pakistan People’s Party to lend legitimacy to the elections.

Ms. Bhutto had bitterly criticized President Musharraf’s six-week emergency rule, imposed in November and lifted Dec. 15, and his measures against the independent judiciary and the press. But she also signaled that she could work with him in a government — a stance that distinguished her from her longtime rival and another former prime minister, Nawaz Sharif. It was Ms. Bhutto’s determination to run in the upcoming election that prompted most other opposition parties, including Mr. Sharif’s, to follow suit and drop threats of an electoral boycott.

Next week’s election is now up in the air. Mr. Sharif, a conservative with backing from Saudi Arabia, said yesterday that his party again intends to boycott the vote. Ms. Bhutto’s party doesn’t have a leader of comparable stature to step into her shoes. Closely intertwined with the Bhutto family, her PPP was established by Ms. Bhutto’s father, former Prime Minister Zulfiqar Ali Bhutto, who was hanged in 1979 by the country’s military rulers. The party announced a 40-day mourning period as it weighs its options.

“It will be extremely difficult to hold elections now,” said Hasan-Askari Rizvi, a Pakistani political analyst who was recently a visiting professor at Johns Hopkins University. “There will be violence.”

Pakistan’s tumult is roiling the capitals of world powers. Continuing chaos is likely to further embolden militants in Pakistan and in neighboring Afghanistan, and may undermine Islamabad’s security cooperation with the U.S.

The U.S. yesterday called for the elections to be held as planned. “We believe the best way to honor Ms. Bhutto is for the democratic process to continue,” State Department spokesman Tom Casey said. To delay the elections, he said, “would be a victory for the assailants.”

Pakistan’s army spokesman, Maj. Gen. Waheed Arshad, said the country’s police can handle the security situation. Interior Minister Hamid Nawaz went on TV to call upon political parties to react peacefully. He said the government was investigating the attack.

Some of Ms. Bhutto’s supporters lashed out at President Musharraf and the government’s security agencies, accusing them of complicity with the killing in Rawalpindi. They questioned whether Ms. Bhutto was given adequate protection in this garrison city, the headquarters of Pakistan’s military.

Ms. Bhutto knew the dangers she faced. In a commentary she contributed to The Wall Street Journal after the Oct. 18 attempt on her life, she said she had asked the government to provide security. “The attack on me was not totally unexpected. I had received credible information that I was being targeted by elements that wanted to disrupt the democratic process,” she wrote.

Since Pakistan was created by 1947’s partition of India, it has never fully gelled as a stable state. The nation’s identity has been premised on a single religion, Islam, and Pakistan provided sanctuary for generations of Muslims who felt oppressed in India or sought their own homeland. But the people of Pakistan have also grappled with a persistent question: How large a role should Islam have in daily life? Very little, say human-rights activists. Total theocracy, counter Pakistanis inspired by the Taliban in Afghanistan.

Sixty Years of Instability

For most of its 60 years of independence, Pakistan has been run by the military, which hasn’t helped resolve the question of religion and state, and in many ways planted the seeds for today’s instability. Pakistan’s military rulers suppressed political dissent in the 1980s and 1990s. At the same time, they provided succor to militants who fought the Soviets in Afghanistan and India in the disputed territory of Kashmir.

Pakistan’s plight stands in stark contrast to its foe and neighbor, India, the world’s largest democracy, which has never experienced a military coup. Since 1947, Pakistan and India have fought three full-scale wars, one resulting in the 1971 secession of East Pakistan, now called Bangladesh. After a group of militants attacked India’s parliament in late 2001, the countries came to the brink of the first war between two declared nuclear powers.

Even Pakistan’s civilian leaders have had to seek the tacit consent of the nation’s powerful military. Ms. Bhutto’s father served as a martial-law administrator under the military, before leading a grass-roots movement that made him prime minister. Mr. Sharif emerged as a national leader while a serving in a military government. The military eventually got rid of both, executing Mr. Bhutto and exiling Mr. Sharif.

Ms. Bhutto rose to prominence in the wake of her father’s death, serving two terms as prime minister in the 1980s and 1990s. The military constrained her involvement in strategic and foreign affairs, and her government was criticized for alleged corruption.

President Musharraf, the former army chief of staff, came to power after ousting Mr. Sharif in a 1999 coup. As a military commander, Mr. Musharraf had cultivated contacts with militants — typically through intelligence services — for their forays into India.

Then came the 2001 terrorist attacks on the U.S., plotted by al Qaeda from Afghanistan. President Musharraf reversed Pakistan’s backing for Afghanistan’s Taliban government. Instead, he provided logistic support to the U.S. military campaign there.

Continued insurgency in Afghanistan, however, has resulted in a creeping Talibanization of parts of Pakistan itself. Groups affiliated with the Taliban and al Qaeda have extended their influence well beyond tribal areas on the Afghan frontier, moving into large parts of the country. In the fall, they overran the Swat valley north of Islamabad, a onetime tourist destination and skiing resort.

Roots of the Crisis

Pakistan’s current crisis began in March, when Mr. Musharraf sought to dismiss the country’s Supreme Court justice, who his government accused of abusing the perks of his office. The move sparked pro-democracy protests, with lawyers and others taking to the streets against Mr. Musharraf.

At the same time, despite resistance among Pakistan’s swelling urban middle class, extremism began reaching into big cities. Earlier this year, Islamic radicals occupied Islamabad’s Red Mosque compound, sending out antivice patrols into the streets of the capital. The months-long occupation drew upon youth educated in religious schools. It ended in July with a bloody commando raid.

Since then, militants